Undoubtedly, vaginal delivery is the most natural and healthy way for both mother and baby. While many women can't wait to experience this miraculous moment, they also worry about the postpartum period.
Normal childbirth, i.e. vaginal delivery of the baby, is undoubtedly the most natural and healthy way for both mother and baby. While many women can't wait to experience this miraculous moment, they also worry about the postpartum period. Can the vagina revert back to the previous condition after it has enlarged enough for the delivery of a big baby?
Can permanent relaxation occur in the vagina during vaginal delivery? What about sexual pleasure? Can both men and women get pleasure from sexual intercourse as much as before the childbirth? Is it possible to go back to the days before childbirth with genital aesthetics? Let's look for answers to all these questions together. In this section, I will give information about the vaginal rejuvenation after vaginal delivery within the scope of 'mommy makeover'.
In life, there are very few things as miraculous as bringing a new life into the world; 9 months of pregnancy, a baby growing inside day by day, the moment of childbirth, and after that... That charming feeling of being a parent, increased responsibilities, puerperium, breastfeeding, changing hormone levels and sleepless nights… Sometimes these can cause people to forget the identities of men and women and get confined in the identity of parents.
Aside from all these, another thing that remains in the minds of couples is whether their sex life will remain unchanged after childbirth, especially after a vaginal delivery.
Thanks to the connective tissue and elastic tissues it contains, the vagina has the ability to stretch enough for a baby to come out. Many women worry if an organ that is tight enough to grasp the penis will not be able to recover after the delivery of the baby. In fact, there are points justifying their concerns about that.
Sometimes even a single vaginal delivery can result in a permanent relaxation. Such a relaxation can also be so much greater that can affect sexual intercourse, especially in women who have had more than 1 vaginal delivery or who have given birth to a large baby, or who have experienced an assisted delivery by forceps or a vacuum.
Of course, this doesn’t mean that the sexual life of every patient who has a vaginal delivery gets negatively affected or she will definitely need vaginal tightening procedure. A sexual intercourse has two parties, so it is affected by not only the female factors but also the male factors. The main point in sexuality is to have the ability to combine enjoyment and pleasure. However, if something goes wrong in the relationship and does not improve over time, a timely intervention with the right procedure is of great importance.
Although it is said that the puerperium takes 40 days, it may take 6 months for the woman’s body to revert back to the previous condition completely. The vagina has the ability to have a quick recovery. Stitches heal within 40 days after birth, and the vagina regains its previous structure.
It is recommended not to start sexual intercourse before the end of the puerperium period. In the first sexual intercourse, couples may experience both problems related to vaginal dryness and problems arising from the vagina, which has not yet fully recovered. Painful sexual intercourse and problems of not getting pleasure are among the most common problems in first relationships after a vaginal delivery.
Women should be advised to do Kegel and Pelvic Floor Exercises during the recovery period after vaginal delivery. In this way, the pelvic floor muscles that weakened during childbirth are strengthened, and the vagina is supported to regain its previous form.
Kegel exercises can also increase the pleasure felt during sexual intercourse. However, sometimes the vagina may not fully regain its previous condition, even though 6 months have passed after childbirth and Kegel exercises have been done regularly. This causes problems in the sexual lives of couples and can also negatively affect the social life of women.
“Vaginal relaxation syndrome” in women and “lost penis syndrome” in men are the conditions commonly encountered due to vaginal relaxation after vaginal delivery. Lack of sexual drive is an inevitable end in a woman who does not feel the penis and cannot get pleasure during intercourse, and who consequently begins to experience orgasm problems.
Similarly, lack of sexual drive may also occur in men, who have difficulty in reaching the climax due to lack of sexual pleasure during intercourse while their penis feels like it is in the air. This can sometimes lead to serious relationship problems between couples. However, a great variety of treatments are available for this condition.
M.E. was a 34-year-old English teacher, working at a private school. She came to my clinic with her 9-month-old baby. She said she had been married for 10 years, she had 2 children, she had a healthy and enjoyable sex life with her husband until 9 months before that day, but had been having serious problems for the last 9 months.
After looking with a bittersweet smile at the baby in her arms, who was giving out smiles as he was unaware of his mother's distress, she said: “Ourfirst child was 8 years old, and years later we wanted to have another baby. We are actually so happy to be parents again but I had a very difficult childbirth. We thought that the problems we experienced during our first sexual intercourse after childbirth were normal. Since the childbirth, I have been doing Kegel exercises. We try to have sex 3 times a week and to experience our previous enjoyable sexual life again, but we can’t! While the penis is inside me, neither I nor my husband feel anything ... We initially did not worry about it. We found ways to satisfy each other, even if we did not enjoy it as much as we did before. However, as the days passed and nothing got better, lack of sexual drive started to develop in both of us. The lack of sexual drive and psychological distress in our sexual life began to be reflected on our domestic life. I think we don't have the previous tolerance and indulgence towards each other. Please help me restore my vagina and my sex life...” my patient continued.
As a result of the gynecological examination, I found that my patient had advanced vaginal relaxation. There was a defect in the perineum, which had been caused by a difficult delivery. Her vagina remained open even at rest, and that condition posed a serious risk for vaginal infections. The absolute solution for M.E. was surgical vaginal tightening, and she wanted the same. She wanted the result of the surgical procedure to be permanent. After the necessary planning, I performed the surgical operation. Three months after the operation, she came with her husband for the control examination. I was used to see flowers in the hands of my patients, but that time my patient’s husband was holding a beautiful bunch of flowers.
“I came to thank you, professor,” Mr. Y. said, and continued: “I was initially strongly opposed to my wife’s desire to have a surgical operation, but luckily my wife was aware of the root cause and you solved it in a really perfect way. Our sex life is almost as enjoyable as in the first days of our marriage. As the pleasure and enjoyment for both of us increased, our lost sexual drive came back, and with our improved sex life, the peace and happiness also returned to our home. … It's just as well that, my wife knocked on your door. Thank you very much again ... "
Many patients knock on a physician's door in panic after vaginal delivery. These patients who are concerned about vaginal relaxation should first be asked how many months ago they gave birth. For a vaginal cosmetic surgery, it is necessary to wait for at least 4 months after a vaginal delivery, but the ideal waiting period is 6 months.
Another question is whether the patient considers having a baby again. Especially after surgical vaginal tightening, vaginal delivery may cause recurrence of the relaxation of the vagina.
When a patient comes for vaginal cosmetic surgery after a vaginal delivery, first her detailed gynecological examination should be performed, and then the answers to the following questions should be sought:
It is very important to determine the exact complaint and main expectation of the patient. In a patient with mild to moderate vaginal relaxation accompanied with lack of sexual pleasure, laser vaginal rejuvenation can be very beneficial, but in patients with advanced vaginal relaxation, absolute solution is surgical vaginal tightening.
Laser vaginal regeneration (LVR) is an energy modality procedure. Besides being a quite safe and effective method, it also have another advantage that it does not require anesthesia. It can be safely preferred especially in patients with mild vaginal relaxation, whose complaints of vaginal dryness or lack of sexual pleasure come to the forefront. It is an ideal procedure that can be performed after childbirth for women who do not want to undergo anesthesia and a surgical operation but want to do something for their sexual life. These advantages come to the fore even more especially for women in lactation period. However, the rate of vaginal narrowing after LVR cannot be more than 30%, so it is very important to inform the patient at the outset.
Surgical vaginal tightening is the most effective procedure for vaginal tightening. Perineoplasty (corrective perineal surgery) can be performed in conjunction with surgical vaginal tightening, and all traces of vaginal delivery can be eliminated to a considerable extent. The vagina can be surgically narrowed to the desired extent and an absolute and permanent narrowing can be achieved. If the patient wants to have a vaginal delivery again, she should be warned that the vagina relaxation may recurrence.
Women who are concerned about the potential adverse effects of vaginal delivery on their sex life should be given detailed information, and their concerns should be addressed saying that even if they have a vaginal relaxation problem, it is a recoverable.
Some of the procedures related to mommy makeover, also known as post-pregnancy cosmetic surgery, are intended for the genital area. Genital aesthetics surgical vaginal tightening, laser vaginal rejuvenation, and RF (radiofrequency) rejuvenation are the most common genital cosmetic procedures intended to increase the sensitivity of the vagina and tighten the vaginal canal. On the other hand, labiaplasty (shortening of the extended labia minora),genital lightening (bleaching),perineoplasty (removal of stitch marks caused by vaginal delivery),majoraplasty (reduction and tightening of the saggy labia majora) also have an important place in this field.
For all couples who have problems in their sexual life after childbirth, it is of great importance to knock the right door, without ignoring their problems. There are a variety of methods that can increase the quality of sexual life. This is possible as long as we care about our sexual health and make an effort to improve it.
Copyright 2023 Assoc. Prof. Süleyman Eserdağ, MD. All Rights Reserved. Legal Warning